Friday, March 21, 2008

The D-1 Experience IV

About 80% of the way through my first year of dental school – and it is time for another reflective installment as to what the first year is all about.

I would like to emphasize that you don’t really feel like you are in dental school most of the time. I am serious. I feel like a grad student of some sort just taking more biology courses so that I can get into dental school. Most of my hours are consumed memorizing signaling pathways for post-translational regulation, or memorizing what the spleen looks like both grossly and microscopically. I understand that we need to be competent health care providers, but am I honestly going to remember 95% of the details I am tested on? The answer is no. All of this first year feels very similar to getting into dental school in the first place - an arbitrary series of hoops to jump through, a rite of passage, whatever. I would be horribly screwed if they put in me in a room to even talk with a patient let alone diagnose anything. Granted, we haven’t taken any courses on patient management yet, but I don’t know how biochemistry will help me recognize caries. All of this studying also dampens your social skills. I feel a bit isolated, in a bubble of factoids and dark rooms with giant projectors. I really wish I could get out more, I hope I remember how to say hello and smile when I start treating real patients.

Again, this is all complaining, and I am downplaying how much I actually HAVE learned. Many things that are so natural now were completely foreign a few short months ago. The hilarity of saying “you got some spinach between 9 and 10” never ceases to amuse. The dental material we have learned so far HAS been quite interesting for the most part - cutting preps, placing restorations, taking gingival plaque indices, and just getting a feel for the many instruments. I wish we spent more time doing that stuff, and my prayers will be answered D-2 year. Granted, I am much better at traditional lecture based classes (because that is all I have ever done), but I enjoy the dentistry aspect so much more..despite struggling in comparison.

In another note, dental radiology is pretty cool. They unfortunately cram too much into our once a week lecture. I am far more interested than I thought I would be, which is great – the lecturers are very engaging as well. I remember bringing my own radiographs in for comp care last semester and wondering…what the hell can you get out of this? It is pretty amazing how the little subtleties and landmarks glare out after a few short weeks of lecture.

Another note is that you are bound to get tired of being the ‘little guy.’ The sterilization people are not the friendliest of people, especially to people that don’t know all the rules. Communication between sterilization and the instructors is also not so hot as we have gotten yelled at for not returning instruments we were told to keep all semester…sigh. It has gotten better, and I haven’t personally had any issues, but I still feel like a lost child sometimes. And yea, setting up your operatory becomes easier, cutting preps becomes smoother, and putting the damn gown on by yourself becomes second nature. Despite all of this, you still feel completely helpless most of the time.

All of the upperclassmen claim how great it feels when the next batch of newbies arrive…I will be taking my board exam around that time too..I can imagine I will feel MUCH older. I coincidentally turn 24 right at the end of august as well, how appropriate.

So at this final stretch point, motivation is the only real road block towards success. There is a lot to do, and time is not abundant. The looming glare of finals also creeps ever closer. It is also fucking snowing and April is one week away. C’mon! I mean, I’m not surprised because I have lived near Chicago most of my life, but you never really get used to it.

So as boring as some of this material can get, it behooves you to pay attention and retain as much as you can. The only reason we take most of these classes is because there is a board exam that is required before one can advance to patient care. Did I mention this exam has changed in the last year or so to be harder (in my opinion). I plan on keeping an NBDE I log when I actually start studying an earnest, but it will suck. I have 3 review books and the dental decks just staring at me from the across the desk…whispering…taunting…NO!

It is just one subject after another this semester, no breaks. Just finished a histo exam, so now I get to celebrate by cramming biochem all weekend. Finished physio last week, treated myself to reading a bunch of required articles, studying for three quizes and the histo test I just took. You get the picture. You really DO get used to it though - which is all the more depressing. But my dad put it best one afternoon while at lunch - "At least there's an ending." SO TRUE! Some people are stuck in terrible jobs their ENTIRE lives. I have to sacrafice some of my youth consumed with basic science...it really seems a small price given how truly wonderful dentistry is as a profession. This train of though keeps me going through the dark and snowy spring.

Wow, 2 posts in 2 days. Give me a medal. Back to biochem I go….last thing in my way before a week of total bliss.

Thursday, March 20, 2008

When Elaborate Memory Tricks Go Beyond Practicality

I meant to post on this a week or so ago, but time has kept my fingers numb. Since the highscore on the neuro midterm was a 95%, the grades all got bumped so that the high would be 100%. This now gives me an ‘A.’ Sweetness? I think so.

But all this neuro talk made me think about studying for that beast of a midterm. I normally study on my own, but at the beginning of this semester, I studied with one of my better friends for the first biochem exam. We both got ‘A’s and consequently have ritualistically had a ‘pre-test pow-wow’ before all the biochem exams. Since we keep getting A’s, we decided to work our magic on other subjects.. namely neuroanatomy.

Now any of you that have studied for an anatomy-based class know that there is just a bunch of random bullshit to memorize that has no relevance outside of taking up precious brain space. Also when you are talking through all this crap with someone else, it is often difficult to remember anything unless you really associate object with function.

Well, let me tell you gang, we came up with the most elaborate and intricate associations that really worked well. Unfortunately, out of sheer boredom, or mutual creativity, we got waaaay off track.

Le example:

Nystagmus is a disorder often associated with the cerebellum and is characteristic of rapid, and shifty eye-movements.

Yea…sounds interesting right? Maybe…

Well it becomes FAR more interesting when Nystagmus suddenly becomes a mythical creature of urban legend that lives under the dental school. So Nystagmus was once a dental student like anyone of us, but he was caught stealing burs from the bin room in times long since passed and was banished below.

Nystagmus slowly became a mutated freak, forced to eat amalgam and wedjets for all eternity. Nystagmus now wants REVENGE… on any hapless dental student that may trek into his lair. If you ever find yourself in that dark hell, you will know he is getting close because you will see eyes shifting madly all over the place as the icy claw of death envelops nearer.

The only way to defeat nystagmus is with light curers…so go prepared. If you defeat nystagmus, you automatically become an oral surgeon-orthodontist, the greatest of dental specialists.

Yea…this may have taken 5 minutes of time to devise. Sure, no question about nystagmus even showed up on the midterm. But I declare to you know, I will NEVER forget what nystagmus means. Ever.

Now If only we could do this with the 10,000 other random minutia I would be gold for the boards.

Histo test tomorrow…why am I not studying and posting crap? Oh yea, I remember – I AM SICK OF BASIC SCIENCE. As soon as histo ends tomorrow, I must crack open the biochem studying because we have another exam next Wednesday…and it’s over 13 some lectures that are insanely detail-oriented….doh. ONE MORE WEEK UNTIL SPRING BREAK!!! GAHHHHHHHHHHHHHHHHHHH!

Friday, March 14, 2008

Pre-Test Zen

Unlike many of my peers, I hate cramming up to the last second for an exam. I have to leave for a physio test in 15 minutes. I stayed up extra late studying, I got up extra early to study more…went to class, came back here for a little since we have time. I finished looking through the lectures for the third time…and I just can’t do it anymore. I mean I had time, but I don’t want to. I think PERFORMANCE on the actual exam is quite important as well and I historically do terribly if I study up to the last second.

I like to find what I call my ‘pre-test zen’ where I completely relax, breathe easy, and jump on in. This week has been a whirlwind and I can’t wait for 1.5 hours from now when I can take my first night off in a month. There were some minor disappointments…got a high B in anatomy instead of that A was I hoping for..but meh – one credit isn’t going to make me lose any sleep. Managed a solid B on the neuroanatomy midterm and seeing as I was worried about even passing the class, I am plenty happy.

None of these minor disappointments can compare to the euphoric feeling I got when I got my first restorative performance exam back. Solid ‘A’… Hell yea! You don’t understand how intimidating this aspect of dental school is when you have zero experience using your hands outside of playing a few instruments and/or videogames. I started out horribly, but practice pays folks. I have gone in on several weekends to simply practice preps and it clearly worked out for me. Granted, half the grade was based on my own evaluation, so my actual prep was probably closer to a B than A..but I DON’T CARE! I am still quite pleased to be doing so well in this class. And it is worth 5 credits..a lot.

Well I also wanted to quickly address all of these emails I am getting. I never expected to get so many, so I must apologize to everyone I haven’t responded to yet…I will get around to it..promise. I feel like an internet celebrity now.

And I gotta go take this damn test now.

Thursday, March 6, 2008

We're Halfway There

Livin' on a prayer.

This past Wednesday marked the official halfway point of this horrid semester. Despite all the stress, anxiety, frustration, and hair-pulling agony – I am actually doing really well. The ever elusive 4.0 is still a reality for me where as last semester, anatomy sorta already had me thinking about damage control. Granted, I still don’t know how I did on the anatomy exams we had 2 weeks ago (but I’m feeling high B low A). My grades aside, the important point I want to get at is TIME MANAGEMENT and KICKING FIRST EXAM ASS.

Pathology for example, this class is a LOT of information. We are quizzed weekly, and I just took the midterm today. The top TEN quizzes count as 40% of your grade in the course. This means you can drop a number of them and end up with a great quiz average. The midterm is worth 20%. I got a really high ‘A’ on it. I calculated how I need to do on the final to get an ‘A’ assuming I keep doing well on the quizzes. I can keep an ‘A’ in pathology with a 65% on the final exam. I’m not saying this to brag. I’m saying this to make you realize how sweet it is to not have a shitload of pressure on you to perform during FINALS. This means you study your ass off at the beginning of the semester. Pretend like it is finals. If you absolutely smoke the first exam or first few depending on the course – you are just setting yourself up for an easy finish. Now if you have to get 90-95%’s on every final, the odds of you pulling that off are much less likely than if you can get C’s on one or two.

Finals are generally more difficult as well..so why not try to get as much leeway as possible. My test taking skills (and guessing skills) seem to be greatly improved this semester as well. Granted, I feel I have somewhat adapted to studying all the time and am more efficient, but at the same time – I go into every test feeling like I could be more prepared (a trend common to many dental students).

Those of you following this blog might also recall I have started dating one of my classmates.. and I have already blown off studying on more than one occasion (don’t care either). We still have managed to be somewhat responsible to our schoolwork...somewhat. Despite all of this, I am doing better than last semester. The classes are so much harder too, I have a feeling it comes back to a motto I said in some post like a year ago. The more you have on your plate, the more organized you become, the better you do. My best semester GPA wise in undergrad was the heaviest course load by far (and I was interviewing for dental school at the same time).

Onto more interesting things, our first REAL performance exam was last Tuesday. I was kind of nervous leading up to the day, but felt pretty good during the test (which is great). A lot of people really freak out during these types of exams and absolutely butcher their preps just because they are extra twitchy. We were allowed to come in an hour early to set up our typodonts and apply the rubber dam. This is a good thing, because rubber dam placement seems to be hit or miss with me sometimes. After getting the dam checked off, I got my class I occlusal prep done on #19 (looks like the bat signal) before filling an amalgam on a pre-prepared #18. Now I had done 5 practice preps/fillings over the weekend and the last one was by far, the best I have done. Unfortunately, during the exam, I didn’t have my perfect game going and fear of blowing out the isthmus really kept me from smoothing the walls. What you need to understand is that we are working on PLASTIC teeth…these things cut like butter, it is tough to smooth anything without greatly expanding your borders. Now the grade is 50/50 on this exam. 50 on quality of work and 50 on self-appraisal. I feel like the quality of my work will be a low-mid ‘B’ (my amalgams still blow and I don’t feel like getting better at them because they will soon be obsolete). However, my self-evaluation should be an ‘A’ of some sort…so the average will hopefully pull me up. The instructors claim that the grading scale is quite generous assuming you don't get any 'standard not mets.' So who knows.

We haven’t gotten the grades yet…and maybe I completely butchered something that I didn’t notice..but it was ‘ok’ I thought. Regardless, the main joy is that I was pretty relaxed. Seeing as we are going to be going through MANY more of these types of exams in the near future – I am glad the stress doesn’t mess with me too much. And despite not doing as well as I would have liked, I actually enjoyed practicing for this thing – dentistry, it is kinda fun I guess. I felt like the time I spent practicing was much better used than when I study for a biochem test. Like I am actually learning practical skills towards my chosen profession!

Well, this week was fairly rough, we have a perio mid-term tomorrow (but it should be a cake-walk). Next week however, will most likely be more hellish than finals last semester (simply because we have to GO to classes still).

Restorative quiz on some random article I haven’t read.
Occlusion quiz on a bunch of lectures regarding stuff I haven’t studied for.
Pathology quiz on neoplasms that should be easy because it was on the midterm
Neuroanatomy midterm……fuck
Physiology exam III (endocrine)…this one is going to be rough as well
Radiology Midterm…sigh

On the plus note, I actually think neuro is starting to come together with me a bit better. I still have a long way to go if I want to get an ‘A’…but it is definitely not as intimidating as 3 weeks ago.

Speaking of finals…I just glanced at the schedule…and it is nuts. I will of course not spoil the surprise this early…I’m sure there will be an elaborate post in the future.

And I’m off.

Ps. Let’s go white sox. Don’t embarrass me this year.